Maternal depletion and child survival in Guatemala and Malaysia

Recent research has shown a strong relationship between birth spacing and child survival in developing countries. While estimates of the size of this relationship vary among countries, the risk of dying for children born after short birth intervals is substantially higher than for children born after longer birth intervals. In this paper the authors investigate the hypothesis that short interpregnancy intervals affect the health of children by preventing women from recovering adequately from one pregnancy before beginning the next. In the first set of analyses in this paper, the authors use data from both Guatemala and Malaysia to investigate the importance of recovery time from the last pregnancy for the survival of the index child in the neonatal period and in infancy. In the second set of analyses, the authors use the longitudinal data collected for women in the Guatemalan villages between 1969-1977 to investigate in more detail the relationship of previous pregnancy interval length and the length of the recuperative interval with maternal nutritional status around the time of conception and during pregnancy and with birthweight. They also investigate the hypothesis that shorter recuperative intervals cause shorter subsequent pregnancy gestation, presumably through greater incidences of cervical incompetence. Finally, the authors use data on maternal weight changes and breastfeeding patterns during the entire interpregnancy interval to look more closely at the process of depletion and recuperation.